Real-time ultrasound to assess the umbilical catheter position in neonates: a randomized, controlled trial

Objective: To compare real-time ultrasound (RT-US) use as an adjunct tool to verify umbilical catheter placement versus standard care without ultrasound. Study design: Neonates requiring umbilical venous catheter (UVC) and umbilical artery catheter (UAC) placement were randomized into the standard formula (No-US) and the RT-US groups. X-rays were used to confirm the catheter position. Result: Fifty and forty-nine neonates were in the RT-US and No-US groups, respectively. RT- US showed a significantly higher rate of initial X-ray-confirmed proper catheter position than No-US (p < 0.001). The rates of proper positions of UVCs and UACs were significantly higher in the RT-US group than in the No-US group (both p < 0.001). Neonates in the RT-US group required fewer catheter adjustments and subsequent X-rays than those in the No-US group. Conclusion: RT-US enhances the accuracy of UVC and UAC placement, reduces catheter adjustments, and the number of X-rays required.